Dr. Patrick M. Forde on Next Steps After CheckMate-026 Study in NSCLC

Patrick M. Forde, MBBCh, assistant professor of oncology, Johns Hopkins Hospital, discusses the CheckMate-026 study, which demonstrated that first-line therapy with nivolumab failed to improve progression-free survival (PFS) in PD-L1—positive non-small cell lung cancer (NSCLC) compared with standard chemotherapy.

Nivolumab-treated patients had a median PFS of 4.2 months compared with 5.9 months for patients treated with a chemotherapy doublet chosen by the treating physician. Overall survival (OS) and response rate also did not differ significantly between treatment groups.

In the second-line treatment of lung cancer in patients that have already received platinum-based doublet chemotherapy, nivolumab does appear to prolong survival over chemotherapy. A lot of oncologists expected to see a similar finding in the first-line setting, says Forde.

It will be very important to look at the population of patients enrolled in the CheckMate-026 study and determine what characteristics of the tumor and the immune environment may have predicted or not predicted response to treatment. There is a lot of work to be done looking back at specimens from that trial to try and determine exactly why nivolumab did not improve survival in this study, says Forde.